Another Day in the Trenches of “The Best Health Care System on Earth”

[McCamy Taylor]

One,the number of people I saw today who have already qualified for permanent medical disability but who will not be eligible for Medicare to treat those medical problems for another two years. Joe got his disability because his heart, lungs and kidneys are failing. He needs a test that will probably cost a thousand dollars and then a treatment that will probably cost a thousand more dollars. This test and treatment are necessary to keep his other health problems from getting worse. There is no way that he can pay for any of this out of pocket, so he will have to wait and keep his fingers crossed. His social security payments are hardly enough to live on, but they make him too “affluent” to qualify for Medicaid which might help him get the specialty treatment he needs. Maybe he can enroll in a study….

Two, the number of people I saw who had to put off necessary tests and treatments for their life threatening conditions, because they lost their insurance. They are among the lucky ones. They have insurance again. I can only guess at the number of folks whom I did not see today who still have not gotten back on their insurance who are foregoing necessary care.

Three, the number of people I saw today who have rare medical conditions that run in their families, who are currently unable to work because of their inherited illness. I try to imagine what it must be like to grow up in a family in which at least one of the parents was always sick and under medical care. The poverty, the uncertainty, lost opportunities for education, the loss of a parent---and now, the never ending cycle of medically induced multigenerational poverty continues. The “Best Health Care System on Earth” should provide for each of us according to our needs. But, instead, those who are most in need of health care get so little, while others of us get tummy tucks, dermabrasion and rhinoplasty.

Four, the number of people who have run out of their medication, because they did not have the money to fill their prescriptions. Some of them have insurance and only have to pay a $10 or $20 copayment. That is $10 to $20 too much for someone who has no job, no home, no car. One of them could have afforded her usual generic medication, but it is in short supply right now---why should drug companies bother making a cheap medication when they can make an expensive alternative instead?---and she can not afford the fancy, new patent version of that drug which costs twenty times as much.

Five, the number of people who had to reschedule appointments because they had either 1) no money or 2) no ride (our city does not have a bus service) or 3) no one to stay at home with the ailing family member whose health is even worse.

Six, the number of times today that I marveled at how folks who have so many problems manage to stay so upbeat. Must be the natural resilience of human beings, because it sure as hell is not a result of the “Best Health Care System on Earth.”

[prairierose]

1. Thank you for posting this...it is important for us to be...

reminded of the reality of this situation on a regular basis.

[bobbolink]

2. Thank you so much for an excellent post!

Do you have any idea what becomes of those people who have applied for disability and still wait? Do you see many of them?

[Kali]

3. are you a health care worker or social services?

thank you for posting this

[McCamy Taylor]

7. Physician. I can only imagine the concentrated misery that social workers see.

[Kali]

8. thanks for your work, as well

[Thav]

42. It's not the providers who are the problem...

The payment systems is. My family and I have been fortunate enough to have excellent providers. The only bad experience I've had is with an oral surgeon. A nurse practitioner saved my wife's life, the nursing staff was excellent when I had my appendix out.

Dealing with insurance companies was a nightmare, though, and I'm still paying for things, up to 5 years after the fact.

I would say that a majority of care givers are excellent, it's too bad people go bankrupt using their services.

Thank you Dr. Taylor for your service.

[laughingliberal]

4. K & R nt

[sad sally]

5. Michael Moore showed America what REAL health care systems look like.

Pretty sure the path we're on right now might be leading lots of us to the promise land alot sooner than we thought - maybe that's the plan.

[maryf]

15. Yep...47,000 a year...

they're shooting for 50,000...

[maryf]

16. self delete

duplicate

[olegramps]

18. In reality they are shooting for 47 million.

The Republicans regard the 47 million without health insurance as being totally expendable. It is their Final Solution to the health care problem and some people still don't believe they are fascists.

[maryf]

21. and up to 84 million on any given day...

as so many critical procedures are deemed unnecessary by the insurance companies...one doesn't need a medical degree these days to diagnose, just a job with a health insurance company...

[cynannmarie]

6. very moving-thanks for writing this-- n/t

[Bozvotros]

9. Thanks for this moving post and here's one more

Seven: The numbers of people getting reduced care because the free clinics, VA hospitals, United Way facilities can only afford so many paid staff and they are forced to see far more people than effective or safe treatment would dictate. Appointments that should be a week apart are routinely put off for a month or two to make room for the growing numbers who have no insurance and no money.

[nadinbrzezinski]

10. Healer remember to laugh

when we see this concentrated tragedy it can eat at your soul, one tragedy at a time.

And no, it is not better than some third world places.

At least we all can go to the ER!!!!!

:sarcasm:

[bertman]

11. Seven, the number of people who have medical insurance but who cannot use it

because they cannot afford to take a day off from work for an appointment, or they cannot afford the copays, or they cannot afford to pay off the deductibles.

REC.

[DesertFlower]

12. K&R. nt

[Hannah Bell]

13. k&r. so true.

[pattmarty]

14. That's why the so called "reform" blows big time. The "good" things.......

...........in the reform could have been passed separately and we wouldn't be stuck with this mess almost no one likes OR understands. OR,,,,,,,,,,,,, we could have passed a incremental form of Medicare for all set up in 5 yr stages of implementation. I guess "we" got what "we" deserved.

[maryf]

17. k&rnt

[The Wizard]

19. The best health care in the world

if you can afford it.

[howmad1]

23. Only if you are a rich, white rethuglican:

....do you get the best health care in the world. Otherwise, you are fucked.

[Quantess]

27. No, you can often get really excellent health care even if you can't afford it.

But you'll be paying for the rest of your life and/or be filing for bankruptcy because of it.

[Scruffy1]

20. As usual -a great post.

[jpak]

22. Yeah that Canadian health care system really sucks

You should move to the States

[Capitalocracy]

24. Argentina offers free medical treatment even if you're a tourist.

Just sayin'.

[Larry Ogg]

25. There's something the founding fathers said that puts our health care system into proper perspective

all experience hath shewn that mankind are more disposed to suffer, while evils are sufferable than to right themselves by abolishing the forms to which they are accustomed.

[truedelphi]

38. Great post. Thanks. n/t

[Paper Roses]

26. Thank you for taking the time to post this information.

My daughter is also a physician(Internal Medicine) and tells me some of the heartbreaking situation she faces every day.
She never uses names. I would not know these people anyway. The situations you in the medical profession face are heartbreaking. Patients with no jobs, no income, major sickness and no hope for the same extensive treatments that those with great insurance or tons of money can afford.

Some of those who criticize the doctors should look deeper. It is not the physicians, it is the system of medical delivery that is killing us.

If Medicare drops the dollar reimbursement to doctors, it will get worse. What Medical Office can keep going with a reimbursement of (currently) $62.00 a patient. Who's making the big dollars here? What about the folks with no insurance? Scared to death that something will happen to them or to a family member. Instant catastrophe.

Blame the big guys, the doctors are trying their best in a truly messed up system.

[shireen]

35. +1

Totally agree.

[woo me with science]

28. K&R nt

[ooglymoogly]

29. Kr nt

[varelse]

30. K&R

As always, thank you for putting the truth out here where we can see and discuss it.

[mdmc]

31. r

[mdmc]

46. ..

[DeSwiss]

32. K&R n/t

[BrklynLiberal]

33. K&R Marked to read later.

[silverweb]

34. Well said.

While I don't see any of these things in person, I hear about them daily. I'm a medical transcriptionist (a very endangered profession, by the way) and do acute care work for 5 different California hospitals.

Patient "noncompliance" because of lack of insurance and funds is absolutely routine, and I hear the frustration in the voices of the doctors dictating their reports. The whole healthcare situation in this country is shameful and infuriating.

The military-industrial complex is the only thing about the United States that is still "best" in the world, and self-congratulation about anything else at all is a complete sham.

Thank you for all you do for your patients and your many informative postings here at DU.

[Johnny2X2X]

36. The new normal

What's sickening is that I think that every American now knows several people who are having their lives shortened by not seeing a doctor right now.

Personally I know several people, as in more than 5, who are suffering unnecessarily with chronic conditions or are not receiving the potentially lifesaving treatment they need. I am middle class, not poor, this is an epidemic. Off the top of my head, I have friends or family members who:

* Do not get the Cholesterol medicine they need.
* Do not get the back surgery they need to even live a normal life and even be able to sit up or walk for more than a minute or 2.
* Do not get the Depression medication they need.
* Will not get a suspicious lump checked out
* Will not get chest pains checked out
etc etc

It's a travesty and an epidemic.

[truedelphi]

37. Every word you say is true. If only we had the honest type of

government that would end this madness.

About a month ago, some form or other was filled out wrong, and it was my turn to go to Social Services to see that the two of us remain on the County paid insurance.

I felt sorry for myself. For the first ten minutes of my life as I sat on the cold hard chair in the waiting room, thinking about how if I had been smart enough to stay in Europe back when I lived there, I wouldn't be spending two days every 90 days dealing with Crapola like this.

Then a woman came in with a caregiver, and she turned to her companion to say something.

I have no idea what affliction had caused this but she had one side of her face in a perpetual grin upwards, so that she looked like the Riddler, and then the other side of her face totally downwards, in the exact slope down that the other hideous side of her face had been going up.

Her words to her companion were slurred, and she had to repeat everything she was saying several times before her companion understood her.

Despite her neat hairstyle, her carefully applied make up and the style of the clothes she wore, her ridiculous expression was the main thing about her you would notice.

All of a sudden, my own cares and problems went right up in smoke.

Sad to think that in some other domicile, Canada perhaps?, the needed cosmetic surgery could have been obtained to help her.

[liberation]

39. That sounds like a stroke victim...

... surgery can do little to help though. :-(

[Swampguana]

40. Thank you for posting this.

[tavalon]

41. Yeah, as a fellow healthcare provider

I snort in derision when people say health care "system". System, it is not. Not even chewing gum and baling wire is keeping this idiocy together. We're being shaken down by the mafia, I mean health insurance companies and it's tearing apart what little system there might have been.

[truedelphi]

44. If FDR were still around to amend his earlier remarks, he'd be saying

That Organized Insurance providers, as well as organized banking interests, are more dastardly than dastardly as organized crime.

[Bozvotros]

43. Meanwhile

It's record setting profits for insurance companies, pharmaceutical companies and for-profit hospitals. These companies are by definition sociopathic, seeking to make ever bigger profits on sickness and injury. Obama needed to grab this by the throat and yet he started right off compromising his positions.

I am convinced that Obama has been threatened in some very real way. I could choose cynically to believe that he planned to campaign on change and then largely maintain the status quo but that goes against my intuition. Something has happened to Obama. He has looked clinically depressed, beaten. Something is very very wrong when the current health care crimes are allowed to continue, changes are diluted and put off for years and the health care pirates continue their pillaging.

And don't get me started on the FDA. They are a joke. They know the pharmaceutical companies are doctoring the research, that doctors get paid to sign off on research they never saw, that Medicare is being bilked for billions in off label use of designer drugs, that drugs are manufactured under substandard conditions and yet they continue to grant patent extensions for the flimsiest of reasons and approvals for medications that have more side effects than benefits. I guess I started myself. Sorry.

[area51]

45. I doubt he got threatened.

Obama just doesn't give a shit about the common person. He's got the republican "I've got mine, fuck you" 'tude.